Effect of framework design on fracture resistance in zirconia 4-unit all-ceramic fixed partial dentures

The purpose of this study was to conduct static load-bearing tests on 4-unit Y-TZP all-ceramic fixed partial denture (FPD) frameworks with different cross-sectional areas and forms to evaluate the influence of connector design on fracture load. Each of the central, mesial and distal connectors was prepared with one of 2 different cross-sectional areas and one of 3 different forms (one circular and two oval forms) to give a total of 18 designs. Five frameworks were then prepared for each design, making a total of 90. Each framework was cemented to the test model with glass ionomer cement. Fracture load was measured with a universal testing machine at a cross-head speed of 1.0 mm/min. A three-way ANOVA revealed significant differences in fracture load depending on cross-sectional area, central connector cross-sectional form, or mesial/distal connector cross-sectional form (p<0.01). No interaction was observed, however, between any two connector design elements. The results of a Tukey analysis revealed a significant difference between the two connector cross-sectional areas investigated, with an increase in connector cross-sectional area resulting in an increase in fracture load. Fracture load decreased as the height of the mesial or distal connector decreased. Fracture load was significantly higher in frameworks in which the height of the central connector was greater than that of the distal or mesial connector. In conclusion, these results suggest that sufficient height needs to be maintained in the mesial/distal connector to secure a high fracture load in zirconia 4-unit all-ceramic FPDs. Moreover, even when this is not possible, a high fracture load may still be obtained by making the height of the central connector as great as possible. Furthermore, extending the connector cross-sectional area is effective in increasing fracture load.